The “Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting” was written in 2004 and is published by the Department of Health and Ageing. The document is a generalised guideline intended as a resource for health care professionals (HCP) to implement and maintain nationally recognised infection control procedures. The guidelines reference a considerable body of research and is endorsed by the Communicable Diseases Network Australia (CDNA).
The entire document can be accessed in PDF format from: Department of Health and Ageing )
Section 22 of the guidelines describes ways that hospitals (“health care establishments”) can minimise the risk of infection transmission. One measure is to instate a policy on health screening and immunisation. This allows the hospital to assess the health and immunisation status of the health care worker at the commencement and throughout the time of employment. Health care workers can then be responsibly employed in environments that pose an acceptable level of risk. An example given in the guidelines is a HCW who has not been naturally infected or immunised against the common childhood conditions such as Varicella Zoster Virus (chickenpox/shingles) . This HCW would be at risk of infection if they were placed in a paediatric ward.
A table outlining the pre employment health checks and testing highlights that HCW should be tested for Tuberculosis and offered vaccinations for influenza, tetanus. hepatitis B, measles mumps and rubella (MMR) and varicella. Some special cases apply where the exposure risk is higher may need other vaccinations and testing.
Furthermore, the document suggests education programs and safe work practices be implemented to further protect the health care worker from work place infection.One way that this document could be used on our wiki-page is as a comparison to the standards that apply at the Royal Darwin Hospital. Section 22 also serves as an additional supporting document for the requirements set out by the Northern Territory Government. There is also some brief information about viral and bacterial conditions such as Varicella and Tuberculosis in section 28 which could provide the basis for definitions on the wiki page. Comment from Thai Interesting find Jane, i think what you have here can be useful to the final wiki in relation to the definition for varicella and tuberculosis, i've got a link that i would post up which has information about the difference in varicella zoster and herpes zoster which would further improve what jane has? I've also got another link that has information about why health care workers need immunization but the information is from an american study, but i think it would also be useful in cnojunction to what Jane has written. Maybe percentage rates of acquiring diseases in a healthcare setting would be interesting?
Authors Seale, Leaske and MacIntyre conducted a survey of 1079 health care workers across two hospitals located in Sydney, NSW. Questions included how much they knew about he vaccination policy of their employer (NSW health) and the attitude towards compliance with the policy.
Background information on the NSW Health policy is given in breif. The 2007 policy directive required health care workers to be “vaccinated against measles, mumps, rubella, diphtheria, tetanus, pertusis, hepatitis B, varicella and be screened for tuberculosis”. If a HCW chose not to be vaccinated, the policy stated that these HCWs would not be permitted to work in certain health care areas. The other option for non-compliant HCWs was to discuss future work options with their employer. Future options included being transferred to non clinical or administrative areas.
Limitations of the study, stated in the report, included the location of the survey and the voluntary nature of the questionnaire. The authors indicated that the data may not have been reproducible in other districts, but the data collected was still of significant value. The HCWs surveyed included Nursing, Medical, Allied health and hospital support staff. The largest number of responses came from the Nursing group. Of the total responses, 22% were male, 74% female and the remainder did not specify.
Responses from the survey indicated that most HCWs comply with compulsory vaccinations on the basis of self-protection. The authors reference other literature to show that HCW consider vaccinations are necessary to avoid personal illness before considering the impact on their patients.
The authors raise an argument that targeting the morals of HCWs can increase voluntary vaccinations, or make compulsory vaccination more acceptable. The authors discuss this argument further with the notion of moral obligation and duty of care of the HCW. The latter arguments in the report delve into the ethics of opposing mandatory vaccination.
The first paragraph of the introduction attributes infection control to immunisation programs which contributes to staff and patient safety. Paradoxically, the document contains statistical evidence showing that HCWs in Australia are poorly immunised against infectious diseases.
I chose this document because the research focused on an Australian setting. The main points that I wanted to address through this document are:
that vaccination policies only work when HCWs are educated about them; and
to highlight that a shift in focus from self-protection to one of beneficence is required. I propose that the document be used as a source for statistical evidence that the majority of HCWs support vaccinations. Furthermore, the document could be used to guide the style and direction of the final Wiki page.
Comment: Thuy Nguyen Jane I think this document is very useful and valid. Not only is it recent, the trial is based in Australia making it relevant to obtain statistics from and to share it with the rest of the students.The discussion on educating about vaccination is something that should be enforced to optimise HCWs understanding, decreasing the impact that non-immunisation can lead to. One of the only negative things that I could say about this document is that only HCWs in NSW are represented and not the whole of Australian HCWs. This may not reflect all HCWs in Australia, and should be taken into consideration as the statistics could be different.
Appraisal #3
Video - Vaccination anatomy Link to Video - Anatomy of vaccinations. This video is produced by A.D.A.M Inc and was updated on the 5 Feb 2010 by two Professors of Medicine at Universities in the USA and the Medical director at ADAM Inc. I found this link through Medline plus. The video is a humours, short introduction into the basic pharmacology of vaccines. What impressed me most about this video is the simple nature in which the message is presented. A reminder of how vaccines work seems timely, even for Health Care Workers who presumably know this content already. I strongly urge the group to consider this video for the final showcase.
Jani I do like the humour yet educational information that it presented from this video. I would like use to use this video as a final show case too. Thuy
The CDC report on the incidence of certain diseases being reported in the NT. This document clarifies some of our questions regarding incidence rates of VZV.
Appraisal #4
This widget is from the Department of Health and Ageing. On the Health Emergency home page there is a section for community groups to grab these "Badges" for use on their own group webpages. So it is free for us to use. The badge links to the DoHA website. I thought the badge would give some colour to our page and demonstrate our use of technology.
Point of clarification
The cost to the new employee for the required vaccinations is NIL. The Australian government pays for some and the rest is paid by the new employees department or section (ie: the pharmacy or the ward).
"The Australian Government under the National Immunisation Program funds some adult vaccinations. However the majority of vaccinations required by DHF staff are not funded and the cost centre of the employee is responsible for costs. Immunisations are recommended for all Remote Staff at any Health Centre, including staff not directly involved in client care and staff working periodically in any Health Centre."
"10.2. Health care workers and other staff at occupational risk of TB Screening for TB is recommended for anyone who engages in direct contact with people at risk of having active TB. Such screening for NT Department of Health and Community Services (DHCS) staff is a compulsory component of employment conditions. Other workers at risk who are not employed by DHCS are strongly recommended to undergo the same screening procedures as outlined below. These guidelines cover staff, volunteers and students. Employers/managers are encouraged to provide education to their personnel in relation to the following recommendations. Screening and any necessary treatment is provided free to employees of both the public and private sectors."
Authority: This information is directly from the NT government website. Scope: Northern Territory government employees, residents of the NT, immigrants and other visitors. Timeliness: Current. Use within the final wiki: Notifying staff that vaccinations are free may increase the uptake of vaccinations and increase monitoring (ie testing). The 'cost' of vaccines to health care workers could be displayed in a simple table.
This a reliable sources as it comes from the NT government website and can be used in the final wiki. It mentions free screening of TB which should come to the attention of all healthcare workers in the NT.Thuy
Vaccines that are free and recommended for adults in the Northern Territory include:
Influenza:
All people 65 years and over
All Indigenous adults 15 years and over
All pregnant women
Anyone over 6 months of age with medical conditions that increase their risk of severe influenza
Pneumococcal vaccine
o All non-Indigenous people 65 years and over
All Indigenous people 15 years and over
MMR
People born after 1960 who have not been vaccinated
Diptheria, Tetanus
At age 50 years or after a tetanus prone injury
HPV
HPV is given as a 3 dose course over 6 months. Females.
Many other vaccines can be recommended for people working in some occupations and people with medical conditions/diseases. These vaccines are often not provided free to the patient and require a prescription to be issued from a general practitioner and the vaccine purchased privately.
Authority: This information is directly from the NT government website. Scope: Adult immunisation schedule. Timeliness: Current. Use within the final wiki: This information is useful in answering which vaccines are free, however we require further information on the cost of occupation specific vaccinations.
Jane, this is a good source because it is directly from the NT government and we want to find out what is specific for the NT. Your right it will be useful if we can find the cost of vaccines used for occupation specific vaccines. Thuy
I agree with Thuy, this information will be very useful in the final document. From my understanding, the federal government recommends vacciantions for the whole country (NIPS which greg has) and provides funding for state and territories to adopt their own schedule to suit their needs (i.e. NT schedule is different to victoria and tasmania as different diseases exist). This doesn't include HCW's, but as you mentioned at the top of your page, certain divisions of DHF in the NT, and other employers are responsible for the funding . Is that others thought? This information needs to be in the final showpiece in a progression, eg NIPS, then NT scedule, then sources on HCW. I have a document from RDH that would be useful in this case. Ross
Aggregated data from the sources above
Immunisation
Paid by
Indicated for
Influenza vaccine
Aus Gov
all territorians
Hepatitis B vaccine
Cost centre
Hepatitis A vaccine
Cost centre
Pertussis
Cost centre
Contact with children
MMR
Cost centre
born after 1960
Varicella Zoster testing and or vaccination
Cost centre
Contact with children
Tuberculosis screening
NT Gov
commencement of employment
References
^ Infection Control Guidelines Steering Committee. Section 22: Protection for health care workers. In: Infection control guidelines. Canberra: Commonwealth of Australia; 2004. p. 57-70.
Table of Contents
Infection control and staff SECTION 22
[1]
Appraisal #1
The “Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting” was written in 2004 and is published by the Department of Health and Ageing. The document is a generalised guideline intended as a resource for health care professionals (HCP) to implement and maintain nationally recognised infection control procedures. The guidelines reference a considerable body of research and is endorsed by the Communicable Diseases Network Australia (CDNA).
The entire document can be accessed in PDF format from: Department of Health and Ageing )
Section 22 of the guidelines describes ways that hospitals (“health care establishments”) can minimise the risk of infection transmission. One measure is to instate a policy on health screening and immunisation. This allows the hospital to assess the health and immunisation status of the health care worker at the commencement and throughout the time of employment. Health care workers can then be responsibly employed in environments that pose an acceptable level of risk. An example given in the guidelines is a HCW who has not been naturally infected or immunised against the common childhood conditions such as Varicella Zoster Virus (chickenpox/shingles) . This HCW would be at risk of infection if they were placed in a paediatric ward.
A table outlining the pre employment health checks and testing highlights that HCW should be tested for Tuberculosis and offered vaccinations for influenza, tetanus. hepatitis B, measles mumps and rubella (MMR) and varicella. Some special cases apply where the exposure risk is higher may need other vaccinations and testing.
Furthermore, the document suggests education programs and safe work practices be implemented to further protect the health care worker from work place infection.One way that this document could be used on our wiki-page is as a comparison to the standards that apply at the Royal Darwin Hospital. Section 22 also serves as an additional supporting document for the requirements set out by the Northern Territory Government. There is also some brief information about viral and bacterial conditions such as Varicella and Tuberculosis in section 28 which could provide the basis for definitions on the wiki page.
Comment from Thai
Interesting find Jane, i think what you have here can be useful to the final wiki in relation to the definition for varicella and tuberculosis, i've got a link that i would post up which has information about the difference in varicella zoster and herpes zoster which would further improve what jane has? I've also got another link that has information about why health care workers need immunization but the information is from an american study, but i think it would also be useful in cnojunction to what Jane has written. Maybe percentage rates of acquiring diseases in a healthcare setting would be interesting?
Apprasial #2
[2]
This document was published in 2009 by Elsevire in the Vaccine publication. Vaccine is the official journal of: International Society for Vaccines, Japanese Society for Vaccinology and the Edward Jenner Society .
Authors Seale, Leaske and MacIntyre conducted a survey of 1079 health care workers across two hospitals located in Sydney, NSW. Questions included how much they knew about he vaccination policy of their employer (NSW health) and the attitude towards compliance with the policy.
Background information on the NSW Health policy is given in breif. The 2007 policy directive required health care workers to be “vaccinated against measles, mumps, rubella, diphtheria, tetanus, pertusis, hepatitis B, varicella and be screened for tuberculosis”. If a HCW chose not to be vaccinated, the policy stated that these HCWs would not be permitted to work in certain health care areas. The other option for non-compliant HCWs was to discuss future work options with their employer. Future options included being transferred to non clinical or administrative areas.
Limitations of the study, stated in the report, included the location of the survey and the voluntary nature of the questionnaire. The authors indicated that the data may not have been reproducible in other districts, but the data collected was still of significant value. The HCWs surveyed included Nursing, Medical, Allied health and hospital support staff. The largest number of responses came from the Nursing group. Of the total responses, 22% were male, 74% female and the remainder did not specify.
Responses from the survey indicated that most HCWs comply with compulsory vaccinations on the basis of self-protection. The authors reference other literature to show that HCW consider vaccinations are necessary to avoid personal illness before considering the impact on their patients.
The authors raise an argument that targeting the morals of HCWs can increase voluntary vaccinations, or make compulsory vaccination more acceptable. The authors discuss this argument further with the notion of moral obligation and duty of care of the HCW. The latter arguments in the report delve into the ethics of opposing mandatory vaccination.
The first paragraph of the introduction attributes infection control to immunisation programs which contributes to staff and patient safety. Paradoxically, the document contains statistical evidence showing that HCWs in Australia are poorly immunised against infectious diseases.
I chose this document because the research focused on an Australian setting. The main points that I wanted to address through this document are:
that vaccination policies only work when HCWs are educated about them; and
to highlight that a shift in focus from self-protection to one of beneficence is required. I propose that the document be used as a source for statistical evidence that the majority of HCWs support vaccinations. Furthermore, the document could be used to guide the style and direction of the final Wiki page.
Comment: Thuy NguyenJane I think this document is very useful and valid. Not only is it recent, the trial is based in Australia making it relevant to obtain statistics from and to share it with the rest of the students.The discussion on educating about vaccination is something that should be enforced to optimise HCWs understanding, decreasing the impact that non-immunisation can lead to. One of the only negative things that I could say about this document is that only HCWs in NSW are represented and not the whole of Australian HCWs. This may not reflect all HCWs in Australia, and should be taken into consideration as the statistics could be different.
Appraisal #3
Video - Vaccination anatomyLink to Video - Anatomy of vaccinations.
This video is produced by A.D.A.M Inc and was updated on the 5 Feb 2010 by two Professors of Medicine at Universities in the USA and the Medical director at ADAM Inc. I found this link through Medline plus.
The video is a humours, short introduction into the basic pharmacology of vaccines. What impressed me most about this video is the simple nature in which the message is presented. A reminder of how vaccines work seems timely, even for Health Care Workers who presumably know this content already. I strongly urge the group to consider this video for the final showcase.
http://www.nlm.nih.gov/medlineplus/ency/videos/mov/200097.mov[3]
Jani I do like the humour yet educational information that it presented from this video. I would like use to use this video as a final show case too. Thuy
For Johnos info
Rates of incidence in the NT - reports from CDCCDC disease control buliten
The CDC report on the incidence of certain diseases being reported in the NT. This document clarifies some of our questions regarding incidence rates of VZV.Appraisal #4
This widget is from the Department of Health and Ageing. On the Health Emergency home page there is a section for community groups to grab these "Badges" for use on their own group webpages. So it is free for us to use. The badge links to the DoHA website.
I thought the badge would give some colour to our page and demonstrate our use of technology.
Point of clarification
The cost to the new employee for the required vaccinations is NIL. The Australian government pays for some and the rest is paid by the new employees department or section (ie: the pharmacy or the ward)."The Australian Government under the National Immunisation Program funds some adult vaccinations. However the majority of vaccinations required by DHF staff are not funded and the cost centre of the employee is responsible for costs. Immunisations are recommended for all Remote Staff at any Health Centre, including staff not directly involved in client care and staff working periodically in any Health Centre."
Guidelines for the control of TB in the NT"10.2. Health care workers and other staff at occupational risk of TB
Screening for TB is recommended for anyone who engages in direct contact with people at risk of
having active TB. Such screening for NT Department of Health and Community Services (DHCS)
staff is a compulsory component of employment conditions. Other workers at risk who are not
employed by DHCS are strongly recommended to undergo the same screening procedures as
outlined below. These guidelines cover staff, volunteers and students. Employers/managers are
encouraged to provide education to their personnel in relation to the following recommendations.
Screening and any necessary treatment is provided free to employees of both the public and
private sectors."
Authority: This information is directly from the NT government website.
Scope: Northern Territory government employees, residents of the NT, immigrants and other visitors.
Timeliness: Current.
Use within the final wiki: Notifying staff that vaccinations are free may increase the uptake of vaccinations and increase monitoring (ie testing). The 'cost' of vaccines to health care workers could be displayed in a simple table.
This a reliable sources as it comes from the NT government website and can be used in the final wiki. It mentions free screening of TB which should come to the attention of all healthcare workers in the NT.Thuy
Free Adult vaccines in the NT
Vaccines that are free and recommended for adults in the Northern Territory include:
- Influenza:
- All people 65 years and over
- All Indigenous adults 15 years and over
- All pregnant women
- Anyone over 6 months of age with medical conditions that increase their risk of severe influenza
- Pneumococcal vaccine
o All non-Indigenous people 65 years and over- All Indigenous people 15 years and over
- MMR
- People born after 1960 who have not been vaccinated
- Diptheria, Tetanus
- At age 50 years or after a tetanus prone injury
- HPV
- HPV is given as a 3 dose course over 6 months. Females.
Many other vaccines can be recommended for people working in some occupations and people with medical conditions/diseases.These vaccines are often not provided free to the patient and require a prescription to be issued from a general practitioner and the vaccine purchased privately.
Authority: This information is directly from the NT government website.
Scope: Adult immunisation schedule.
Timeliness: Current.
Use within the final wiki: This information is useful in answering which vaccines are free, however we require further information on the cost of occupation specific vaccinations.
Jane, this is a good source because it is directly from the NT government and we want to find out what is specific for the NT. Your right it will be useful if we can find the cost of vaccines used for occupation specific vaccines.
Thuy
I agree with Thuy, this information will be very useful in the final document. From my understanding, the federal government recommends vacciantions for the whole country (NIPS which greg has) and provides funding for state and territories to adopt their own schedule to suit their needs (i.e. NT schedule is different to victoria and tasmania as different diseases exist). This doesn't include HCW's, but as you mentioned at the top of your page, certain divisions of DHF in the NT, and other employers are responsible for the funding . Is that others thought? This information needs to be in the final showpiece in a progression, eg NIPS, then NT scedule, then sources on HCW. I have a document from RDH that would be useful in this case. Ross
Aggregated data from the sources above
References
Vaccines [video animation on the internet]. 1'16''. A.D.A.M. USA. 2010 [Cited: 2010 Aug 5] Available from: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000137.htm.